MDS 3.0 Use of Dashes

A memo titled "The Use of Dashes in Completing the MDS 3.0 Assessment: Potential Impact to Beneficiaries and Nursing Home Facilities" has been posted under Downloads at http://www.cms.gov/NursingHomeQualit...gMaterials.asp on the CMS website. This memo conveys information to providers regarding the possible overuse of dashes. It is intended to help providers understand when to code dashes and the potential adverse impact of inappropriate use of a dash (-) when completing a MDS assessment.

Dear CMS, Nurse Assessment co-ordinators do not WANT to use dashes, but we are not writing fiction here. If we don't know by documentation by interview, we are not really supposed to glean this information from the chart anymore. It's interview or dash. Prior to 3.0 I had not used ten dashes in 8 years. Every discharge assmt I do now has a few dashes, and I cannot get the interviews done in the time frame prescribed by CMS. Staff interviews on pain after the patient leaves are not within the prescribed time frames. YOU are the ones that told us to dash what we don't know.
ST

My exact thoughts as well.....
I use dashes on many assessments due to the fact that the pain assessments have not been done during the appropriate time frame.
Not gonna falsify to make the assessment look "complete".

I use pain assessment from the MARs in which the nurses doc qshift, our dept has d/c assessments closed within a week from d/c date. According to the attachment from CMS you can use nursing notes and documentation prior to d/c. so that is why daily notes are so important.

Our software has a wizard that autopopulates a date of interview. If I use nursing notes, I cannot use the wizard, which is fine by me, but seems to be causing panty knots at corporate...... Not liking me doing the MDS from the chart. Also not giving me enough help. I have a hesitation about prioritizing the dc MDS because if we all comply (by getting so much overtime we have no other life) it will definitely not be on the radar at CMS. They need to do away with this MDS, or shorten it dramatically.

I totally agree that this MDS needs to be revamped. We have so many unplanned discharges it is ridiculous. I try not to use dashes, but as you say, if the interview was not completed, we can not falsify the MDS! I can understand interviewing the residents annually, but with every assessment, it is ludicrous. I can only pray that CMS will wake up and revise MDS 3.0.

The whole MDS system is a joke, I started with the 2.0, easy enough, interviewing a pt. 3 times in 21 days is a bit much, always using dashes, esp. with discharges that happen when I am not here. The STATE comes in and pretends like they know it all, they are usually in a bad mood, because they are always on the road, and under paid., I could ramble on ...................

The whole MDS system is a joke, I started with the 2.0, easy enough, interviewing a pt. 3 times in 21 days is a bit much, always using dashes, esp. with discharges that happen when I am not here. The STATE comes in and pretends like they know it all, they are usually in a bad mood, because they are always on the road, and under paid., I could ramble on ...................

Also, and I am sure a surveryor would argue on this point, no surveyors are MDS experts, not even the beloved QUAN, yet....and I just had a surveryor tell me, with a straight face, she/he had NEVER seen this patient make movements...seems my 2 years of caring for him/her were instantaneousy erased when she OBSERVED him one afternoon, with her handy laptop to provide, I guess, a PICTURE of him that told it all...lol

Also, and I am sure a surveryor would argue on this point, no surveyors are MDS experts, not even the beloved QUAN, yet....and I just had a surveryor tell me, with a straight face, she/he had NEVER seen this patient make movements...seems my 2 years of caring for him/her were instantaneousy erased when she OBSERVED him one afternoon, with her handy laptop to provide, I guess, a PICTURE of him that told it all...lol